[Adventures and misadventures of solitary sailors on the sea of uncertainty].
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US health care providers who are not familiar with cutaneous leishmaniasis may now begin to encounter more patients with this challenging entity as military personnel return from rotations in Iraq or Afghanistan. Diagnosis requires a skin scraping, aspiration, or biopsy, followed by examination by an experienced microscopist or pathologist. Demonstration of the parasite DNA by PCR or culture in special media can also be used to confirm the diagnosis. Sodium stibogluconate is the mainstay of therapy, but other options for selected cases include topical thermal or cryotherapy treatment and oral triazole compounds. Assistance is available through the CDC and, for Department of Defense beneficiaries, certain military facilities.
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A study made during a long-continued voyage discloses some of the cause-effect connections in social and psychological, social and economic, physiological and hygienic factors. A particular feature of the present paper is the study of the above-named factors in age- and occupation-related aspects. The following factors were found out to have a negative effect on ship personnel (in a decreasing rank order): sailing for more than 6 months, continence, vibration, air temperature, noise, a chemical factor, ship diet, atmospheric moisture, and air motion. Most common during a long-continued cruise are symptoms of bodily discomforts manifested by undue fatigue, low working capacity, a restless sleep, abnormal irritability, depressed mood.
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